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目的:探索眼科内眼手术前后结膜囊细菌学变化特点及临床眼科用药效果。方法:133眼需要行内眼手术的连续病例包括白内障手术68眼、青光眼手术39眼、视网膜脱离手术20眼、玻璃体切割术6眼。用133眼内眼手术病人手术前后的结膜刮片及68眼白内障手术术毕的前房冲洗液作细菌培养,并作药敏试验。结果:133眼内眼手术患者入院时结膜刮片作细菌培养有61眼(45.85％)培养出细菌,其中金黄色葡萄球菌23眼、表皮葡萄球菌25眼、G~+杆菌13眼;手术消毒前结膜囊刮片有8眼(6％)仍培养出细菌,其中金黄色葡萄球菌3眼,表皮葡萄球菌5眼;68眼白内障手术患者前房冲洗液中仅1眼(1.5％)培养出细菌,为表皮葡萄球菌;术毕时结膜刮片4眼(3％)培养出细菌,所培养出来的细菌均对妥布霉素、庆大霉素、先锋Ⅵ、万古霉素和利福平敏感,而对四环素、氯霉素、红霉素、氧氟沙星耐药。结论:肉眼手术前应用有效抗菌素至为重要,可预防眼内炎的发生,但不可轻视手术无菌操作。眼科学报1999;15:267-269。
Objective: To explore the characteristics of bacteriological changes of conjunctival sac before and after intraocular ophthalmic surgery and the clinical efficacy of ophthalmology. Methods: Thirty-three consecutive cases requiring intraocular surgery included cataract surgery 68, glaucoma 39, retinal detachment 20, and vitrectomy 6. With 133 intraocular eye surgery patients before and after surgery conjunctival scraping and 68 eyes of cataract surgery completed anterior chamber irrigating fluid for bacterial culture and drug susceptibility testing. Results: 61 eyes (45.85%) of conjunctival scraps were cultured in the eyes of 133 eyes. There were 23 eyes of Staphylococcus aureus, 25 eyes of Staphylococcus epidermidis and 13 eyes of G ~ + bacilli. Surgical disinfection Bacteria were still cultivated in 8 eyes (6%) of the former conjunctival scraping blades, including 3 of Staphylococcus aureus and 5 of Staphylococcus epidermidis. Only 1 of the 68 eyes (1.5%) of the anterior chamber irrigated cataract patients were cultured Bacteria were Staphylococcus epidermidis. Bacteria were cultured in 4 eyes (3%) of the conjunctival scraping blades at the end of operation. All the bacteria cultured were resistant to tobramycin, gentamicin, vanguard Ⅵ, vancomycin and rifampicin Sensitive, and tetracycline, chloramphenicol, erythromycin, ofloxacin resistance. Conclusion: It is important to use effective antibiotics before macroscopic surgery to prevent the occurrence of endophthalmitis, but it can not be underestimated. Journal of Ophthalmology 1999; 15: 267-269.